The COVID-19 pandemic has posed significant challenges to healthcare, including cancer diagnosis and treatment. One concerning trend is the lower-than-expected cancer diagnosis rates attributed to the pandemic’s impact on healthcare systems and patient behavior. A recent US population-based cross-sectional study revealed that cancer diagnosis rates improved in 2021 after significant disruptions caused by the pandemic. However, the rates have remained lower than expected, resulting in an increased deficit of diagnosed cases. The findings were published in the Journal of the American Medical Association.
A previous study by the same research team found that the incidence of all-site cancers in the US was significantly lower than expected from March through December 2020.
You would think all this is good news, but a little deeper analysis will prove otherwise.
The pandemic has led to widespread postponement and cancellation of routine cancer screenings, as well as a decrease in patient visits to healthcare facilities for symptoms that may warrant further investigation. As a result, many individuals with undiagnosed or early-stage cancer may not have had the opportunity for timely detection and intervention.
The investigators found 134,395 potentially undiagnosed cancer cases, indicating a significant unmet need. There were notable variations in cancer diagnosis rates across different cancer stages, specific cancer sites, and population subgroups. It is unclear whether cancer rates have recovered since the COVID-19 pandemic.
The study included 1,678,697 reported cancer cases from the National Cancer Institute’s Surveillance, Epidemiology, and End Results 22 (SEER-22) Registries Database. Their final model estimated that the incidence of cancer in all sites was 9.4% lower than expected in 2020 and 2.7% lower in 2021, resulting in a substantial overall reduction of 6.0% across both years.
Regarding missed cases, the investigators found that this decrease in diagnoses resulted in 149,577 potentially undiagnosed cases during the first 2 years of the coronavirus pandemic, with 33,226 undiagnosed cases in 2021 alone.
Diagnosis rates by stage were estimated to be significantly lower than expected for both early—and late-stage disease in 2020. However, early-stage diagnoses had significantly lower rates than late-stage ones. In 2021, there was no serious disruption to either early—or late-stage cancer diagnoses.
In 2021, cancer incidence across all sites had returned to pre-pandemic levels for females, people under 65 years old, and non-Hispanic Asian and Pacific Islanders. However, it remained significantly lower for males, people 65 and older, Hispanics, as well as non-Hispanic Black and White people.
The drop in cancer diagnosis rates in 2020 was partly due to fears of COVID-19, which was particularly prevalent among women and the younger generations. With the availability of COVID-19 vaccines in the US in 2021, there was a significant increase in cancer diagnosis rates, especially among young women. Researchers emphasized the need for increased investment in nationwide cancer surveillance to improve the speed, quality, and consistency of cancer data.
This delay in cancer diagnoses could have far-reaching implications for those affected, as early detection is crucial for favorable treatment outcomes and survival rates. Healthcare providers need to address the challenges posed by the pandemic.
The investigators concluded by cautioning: “Particular attention should be directed at strategies to immediately increase cancer screenings to make up lost ground and prevent a future surplus of late-stage diagnoses.”
We couldn’t agree more.
Source:
https://jamanetwork.com/searchresults
https://my.clevelandclinic.org/health/diagnostics/22607-cancer-stages-grades-system
https://seer.cancer.gov/registries/terms.html